A 41-year-old female presented with a meningioma of the craniocervical junction manifesting as tetraparesis and vesicourethral dysfunction. Neuroradiological examinations showed a homogeneous enhanced mass lesion extending from the foramen magnum to the upper aspect of the second vertebral body. The tumor was totally removed via the transcondylar fossa approach, which is one type of the lateral approach. She was discharged without neurological deficits. The transcondylar approach is often utilized for lesions that occupy the ventral portion around the foramen magnum. The transcondylar fossa approach, a variation of the transcondylar approach, is a refined technique which obtains a closely similar surgical working field. Use of the transcondylar fossa approach remains controversial when treating patients with little brain stem dislocation, a small condylar fossa, and a protruding occipital condyle, but the approach can easily be converted to the transcondylar approach. The transcondylar fossa approach could become a standard method to access the craniocervical junction.